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Long-lasting contraception for parents

There are some good alternatives to the pill or condoms, that allow you to control when you get pregnant, without affecting your fertility.

Posted: 3 July 2007
by Laura Lee Davies

Whether you have already had a child and are looking to ensure against a future unplanned pregnancy, or you are thinking about contraception options which are secure, you might be interested to know that 'long-acting, reversible contraception' (LARC) is finding increasing support in medical circles.
The Family Planning Association and NICE (the National Institute for Clinical Excellence) have both come out in support of wider use of LARC as a preferable solution for women in long-term relationships. This is because, unlike the pill, you are more likely to be able to conceive more swiftly after using it, if there are no other unforeseen physical reasons why conception is proving a problem. Plus, whilst it does not protect against sexually transmitted diseases, it is a very efficient way of protecting against unwanted pregnancy.

What is LARC?
Long-acting reversible contraception is an alternative to having to use a daily pill or one-off contraceptives like condoms.
There are various different options:

IUD The intrauterine device used to be called the coil. It is implanted in the womb with two fine threads protruding from the cervix into the top of the vagina. IUDs now contain more copper and are 99 per cent effective. The device works by stopping the sperm from reaching the egg, or in some cases, it works by preventing a fertilised egg from implanting in the womb.
There are different sizes to suit different women's bodies, and a device can be fitted to last three to 10 years. It is fitted by a doctor or nurse.
Health experts are at pains to assure women that it is not preventing pregnancy by bringing about an abortion in any form.

IUS The intrauterine system is a small, plastic T-shaped device (supplied in the UK by Mirena) which is also fitted by a doctor or nurse, into the womb, with soft threads which hang down through the cervix.
The IUS slowly releases a progesterone hormone which is like the natural progesterone given off by your body. This has the effect of thinning the lining of the womb and thickens the mucus in the cervix, making it more difficult for sperm to successfully fertilse an egg or for an egg to successfully implant in the womb. In some cases, women stop ovulating but this is not the majority experience.
It is 99 per cent effective and will last up to five years.

Implant The contraceptive implant is a small soft rod, implanted into the skin at the top of the arm. It releases progesterone similar to that produced naturally by your body. It will last for up to three years.
It works in the same way that an IUS (above) will: by thinning the lining of the womb and thickening the mucus from the cervix.

Injection The contraceptive injection contains a progesterone hormone similar to that which your body produces naturally. It works as the IUS and Implant (both above) in that it helps to thin the lining of the womb and thicken the mucus of the cervix, preventing sperm from successfully uniting with an egg or stopping the egg from successfully implanting in the womb.
There are two different injections, Depo-Provera lasts for 12 weeks, and Noristerat which lasts for eight weeks.

Why choose a LARC?
Many couples who have had children want to be able to control when and if they have any more children.
Research has shown that busy parents are at risk from forgetting to take a daily form of contraception and are loathe to act on sterilisation, which is almost always irreversible (shutting the door on the possibility of having more children).
The plus to LARCs is that once they are removed or no longer administered, the woman returns to her natural level of fertility immediately, where the pill can stay in the system for some time.
Many people prefer them because they do not interfere with the spontaneity of sexual intercourse.

The one thing to bear in mind with the daily pill or any LARC, is that they do not create a barrier to protect against any sexually transmitted disease.

For more valuable information on various forms of routine and emergency contraception, visit the The Family Planning Association website.

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